摘要
目的探讨布拉氏酵母菌联合熊去氧胆酸治疗直肠型溃疡性结肠炎(UC)的疗效及对肠黏膜屏障功能的影响。方法将88例直肠型UC患者随机分为观察组和对照组,每组44例。比较2组患者治疗前后主要症状(腹痛、腹泻、脓血便)评分、炎症性肠病问卷(IBDQ)评分、炎性因子指标[白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]水平及肠黏膜屏障功能指标[尿液乳果酸与甘露醇的比值(L/M)、血清D-乳酸(D-LA)、血清二胺氧化酶(DAO)、血清脂多糖(LPS)]水平。比较2组不良反应发生情况。结果治疗后,2组腹痛、腹泻和脓血便评分均较治疗前降低,IBDQ评分高于治疗前,且观察组腹痛、腹泻和脓血便评分低于对照组,IBDQ评分高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清D-LA、DAO、LPS和尿中L/M均降低,且观察组上述指标水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清IL-6、TNF-α和IL-1β水平降低,且观察组上述指标水平低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为86.36%,高于对照组的68.18%,差异有统计学意义(P<0.05)。2组下腹部疼痛、过敏、顽固型便秘等不良反应发生率比较,差异无统计学意义(P>0.05)。结论布拉氏酵母菌联合熊去氧胆酸治疗直肠型UC患者疗效显著,能够有效改善腹痛、腹泻和脓血便等症状,抑制机体炎症反应,缓解肠黏膜屏障受损。
Objective To investigate the efficacy of Saccharomyces boulardii combined with ursodeoxycholic acid in the treating rectal ulcerative colitis(UC)and its influence on intestinal mucosal barrier function.Methods A total of 88 patients with rectal UC were randomly divided into observation group and control group,with 44 cases in each group.The scores of main symptoms(abdominal pain,diarrhea,purulent stool),score of the Inflammatory Bowel Disease Questionnaire(IBDQ),levels of inflammatory factor indicators[interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)]and levels of intestinal mucosal barrier function indicators[the ratio of urinary lactolic acid to mannitol(L/M),serum D-lactic acid(D-LA),serum diamine oxidase(DAO),and serum lipopolysaccharide(LPS)]were compared between the two groups before and after treatment.The incidence of adverse reactions were compared between two groups.Results After treatment,the scores of abdominal pain,diarrhea and purulent stool in both groups were significantly lower than those before treatment,while the IBDQ score was significantly higher than that before treatment,and the scores of abdominal pain,diarrhea and purulent stool in the observation group were significantly lower than those in the control group,while the IBDQ score was significantly higher than that in the control group(P<0.05).After treatment,the levels of serum D-LA,DAO,LPS and urinary L/M in both groups reduced significantly,and the levels of these indicators in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of serum IL-6,TNF-α and IL-1β in both groups reduced significantly,and the levels of these indicators in the observation group were significantly lower than those in the control group(P<0.05).The total effective rate inthe observation group was 86.36%,which was significantly higher than 68.18% in the control group(P<0.05).There were no significant differences in incidence rates of adverse reactions such as lower abdominal pain,allergies and refractory constipation between two groups(P>0.05).Conclusion Saccharomyces boulardii combined with ursodeoxycholic acid is effective in the treatment of patients with rectal UC,which can effectively improve symptoms such as abdominal pain,diarrhea and purulent stool,inhibit the inflammatory response of the body,and alleviate damage to the intestinal mucosal barrier.
作者
韩轩
韩叙
程砚儒
代金玉
HAN Xuan;HAN Xu;CHENG Yanru;DAI Jinyu(Department of Gastroenterology,Langfang City People's Hospital in Hebei Province,Langfang,Hebei,065099)
出处
《实用临床医药杂志》
CAS
2024年第1期73-77,共5页
Journal of Clinical Medicine in Practice
基金
河北省2021年度医学科学研究课题(20210238)。
关键词
布拉氏酵母菌
熊去氧胆酸
直肠型溃疡性结肠炎
肠黏膜屏障功能
炎性因子
不良反应
Saccharomyces boulardii
ursodeoxycholic acid
rectal ulcerative colitis
intestinal mucosal barrier function
inflammatory factors
adverse reactions
